Purpose Adults with Cerebral Palsy (CP) often report an earlier decline in mobility when ageing than typically developing (TD) peers. Part of this decline might stem from alterations in exercise-induced fatigability. The current investigation aimed to compare age-related changes in fatigability between individuals with CP and TD peers. We hypothesized greater age-related increase in exercise-induced fatigability in adults with CP than TD peers. Methods Young (CPY; 18–25 years; n=7) and older (CPO; 35–50 years; n=8) adults with CP were included and matched to TD counterparts (TDY/TDO). Participants completed an incremental fatiguing protocol up to task failure on a bike equipped with built-in force transducers, allowing a rapid switch to isometric strength measurement. Each stage lasted 3 minutes and was immediately followed by a neuromuscular function evaluation before increasing the cycling power for the next stage. Neuromuscular evaluation allowed us to measure knee extensor isometric maximal force (MVC), voluntary activation (VA), and potentiated twitch (TwPOT) amplitude at baseline (Pre), after each stage, and at task failure. Results At Pre, CPO exhibited lower MVC (CPO: 141 ± 31, lowest other group: 247 ± 117 Nm) and TwPOT (CPO: 50 ± 20, lowest other group: 84 ± 15 Nm) compared to all other groups and VA was lower in CPO than in TD groups (CPO: 70 ± 9, lowest TD group: 89 ± 4 %). The fatiguing task led to an earlier task failure amongst CPO compared to all others (CPO: 5.01 ± 0.68, lowest other group: 6.92 ± 1.23 stages completed). During the common stages, CPO exhibited an earlier and more pronounced decrease in MVC (CPO: 37 ± 12, lowest other group: 51 ± 8 % of Pre at last common stage) and VA (CPO: 71 ± 24, lowest other group: 88 ± 15 % of Pre at last common stage) at most timepoints than other groups. TwPOT force amongst CPO was only different to CPY following the second stage. At task failure, CPO showed an attenuated decrease in TwPOT force compared to TD groups (CPO: 70 ± 25, lowest TD group: 38 ± 12 % of Pre). No differences between groups were noted for MVC nor VA at task failure. Conclusion Earlier fatigue was noted in older participants with CP compared to younger participants, and to age-matched TD participants for a given relative workload. This difference in fatigability during the common stages may reflect greater central alterations (VA).

Exercise-induced fatigability is exacerbated amongst older adults with cerebral palsy compared to younger counterparts

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发表日期：

2026年3月31日

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Anders Emil Ejskjaer Gravholt,
Bruno Fernandez,
Louis Chauvet,
Narimane Zeghoudi,
Guillaume Y. Millet,
Annemieke I. Buizer,
Thomas Lapole

摘要

Purpose

Adults with Cerebral Palsy (CP) often report an earlier decline in mobility when ageing than typically developing (TD) peers. Part of this decline might stem from alterations in exercise-induced fatigability. The current investigation aimed to compare age-related changes in fatigability between individuals with CP and TD peers. We hypothesized greater age-related increase in exercise-induced fatigability in adults with CP than TD peers.

Methods

Young (CP_Y; 18–25 years; n=7) and older (CPO; 35–50 years; n=8) adults with CP were included and matched to TD counterparts (TD_Y/TD_O). Participants completed an incremental fatiguing protocol up to task failure on a bike equipped with built-in force transducers, allowing a rapid switch to isometric strength measurement. Each stage lasted 3 minutes and was immediately followed by a neuromuscular function evaluation before increasing the cycling power for the next stage. Neuromuscular evaluation allowed us to measure knee extensor isometric maximal force (MVC), voluntary activation (VA), and potentiated twitch (Tw_POT) amplitude at baseline (Pre), after each stage, and at task failure.

Results

At Pre, CP_O exhibited lower MVC (CP_O: 141 ± 31, lowest other group: 247 ± 117 Nm) and Tw_POT (CP_O: 50 ± 20, lowest other group: 84 ± 15 Nm) compared to all other groups and VA was lower in CP_O than in TD groups (CP_O: 70 ± 9, lowest TD group: 89 ± 4 %). The fatiguing task led to an earlier task failure amongst CP_O compared to all others (CP_O: 5.01 ± 0.68, lowest other group: 6.92 ± 1.23 stages completed). During the common stages, CP_O exhibited an earlier and more pronounced decrease in MVC (CP_O: 37 ± 12, lowest other group: 51 ± 8 % of Pre at last common stage) and VA (CP_O: 71 ± 24, lowest other group: 88 ± 15 % of Pre at last common stage) at most timepoints than other groups. Tw_POT force amongst CP_O was only different to CPY following the second stage. At task failure, CP_O showed an attenuated decrease in Tw_POT force compared to TD groups (CP_O: 70 ± 25, lowest TD group: 38 ± 12 % of Pre). No differences between groups were noted for MVC nor VA at task failure.

Conclusion

Earlier fatigue was noted in older participants with CP compared to younger participants, and to age-matched TD participants for a given relative workload. This difference in fatigability during the common stages may reflect greater central alterations (VA).